COMPLETEALLSECTIONS.INCOMPLETEAPPLICATIONSWILLNOTBEREVIEWED

DiversityScholarship Program

2017-2018Application

Freshmen ApplicationDeadline: Thursday,December 1, 2016

Please note, if you plan to mail or drop off a paper application it MUST be in our officeonDecember 1, 2016, by 5:00 pm. Applications submitted online or faxed MUST be in our office, SMSU 425, on or before December 1, 2016 by11:59 pm.

Purpose:

ThepurposeoftheDiversityScholarship Programistoexpandandenrich Portland State's learning community byrecognizingandsupportingoutstandingstudents fromfirstgeneration andvariouscultural, ethnicandsocio­ economicbackgrounds,with diversetalents,interests, andlifeexperiences.TheDiversityScholarship Programis committedto helpingstudentsachievetheiracademicgoals.Theprogrampromotesdiversityandstudent participationincampuslifethroughvolunteerism andacademicexcellence.Scholarshiprecipientswillsharetheir uniquestrengthsanddiverseperspectivesthroughtheirinvolvementin on-campusactivities,in theclassroomandthrough theirparticipationincommunityservice.TheDiversityScholarshipisa tuition-remissioncreditintheamountof12 undergraduatecreditsattheresidenttuitionrateexcludingfees(actualamountvaries).

Eligibilityrequirements: HighSchoolStudents

•Fewerthan30 collegecreditswitha3.0cumulativehighschoolGPAorGEDcompletion(55totalscoreorbetter)

•Musthaveapplied for admissionsto PortlandStateUniversitybyDecember 1, 2016

•MustenterPortlandStateUniversityinfall2017

Incomingtransferstudents

•Minimumof30transferablecollegecredits,butnomorethan134creditswith2.50cumulativecollege-levelGPA

•Mustbeworkingtocompletefirstbachelor’sdegree

•Musthave applied for admissions to PortlandStateUniversitybyFebruary 1, 2017

•MustenterPortlandStateUniversityinfall2017

CurrentPSUundergraduates

•Nomorethan134creditswith2.50cumulativecollege-levelGPA

•Mustbeworkingtocompletefirstbachelor’sdegree

SelectionCriteria:

ThescholarshipisawardedtostudentswhobestexemplifythepurposeoftheDiversityScholarship Program.Priorityfor theDiversityScholarshipisgiventoOregonresidentswithhighfinancialneedasdefinedby federalguidelinesandwhoare“first-generation”collegestudents(neitherparenthasafour-yearcollegedegreefromany country).Internationalstudentsarenoteligibleforthisscholarship.

Basedontheabovedescription,areyouafirst-generationstudent?Yes No

Haveyoubeenadmitted?YesNoIfno,whatdatedidyouapplyfor admissions?______

HaveyousubmittedaFASFA(FreeApplicationforFederalStudentAid)?YesNo

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FIRSTNAMEMIDDLEINITIALLASTNAMEPSUSID

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STREETADDRESSTELEPHONE

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CITYSTATEZipCodeCELLPHONE

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PRIMARYEMAILADDRESSBIRTHDATE

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DATEORTERMADMITTEDTOPSUIFADMITTEDWITHCONDITIONSPLEASELISTTHECONDITIONS:

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HIGHSCHOOLATTENDEDGRADUATION DATE

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COLLEGE(S)ATTENDEDCREDITS DATES

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COLLEGE(S)ATTENDEDCREDITS DATES

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COLLEGE(S)ATTENDED CREDITS DATES

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COLLEGECREDITSTOTALINTENDEDMAJOR(S)ORAREAOFSTUDY

Highestlevelin schoolyourfatherorguardiancompleted:

Master’s/Ph.D./M.D./J.D.

Bachelor’sdegreefroma U.S.CollegeorUniversity

Bachelor’sdegreefromcountry outsidetheU.S.

Somecollege/Associate’sdegree

Highschool/GED

Did notgraduatefromhighschool

Unknown

Highestlevelin schoolyourmotherorguardiancompleted:

Master’s/Ph.D./M.D./J.D.

Bachelor’sdegreefroma U.S.CollegeorUniversity

Bachelor’sdegreefromcountryoutsidetheU.S.

Somecollege/Associate’sdegree

Highschool/GED

Did notgraduatefromhighschool

Unknown

Race/Ethnicity:Youareencouragedtosupplythisinformation.However,youmaydeclinewithoutcompromising yourapplication.

Pleasecheckany/allthatapply:

A–Asian(Country)_

PI–PacificIslander

H –Hispanic/Latino

AF–African-

ME –Middle Eastern

B –Black(Non-Hispanic)

W–White(Non-Hispanic)

O– Other

I –AmericanIndianorAlaskanNativeD –Declinetorespond

A.Essay(required)–Printortypeyournameandstudentidentificationnumberoneachpage

Pleaseprovideshortanswers(Maximumof400wordsforeachquestion)toallofthefollowingquestions:

  1. Given your personal background, describe an experience that illustrates what you would bring to the

diversity at Portland State University?

2.Howhasyourdiversity(culturalheritage,race,gender, socio-economic background,family,work,and/orschool experiencesetc.)contributedtowhoyouaretodayandyourpursuitofa collegeeducation?

3. Whatfinancialchallengesdoyouanticipateencounteringasyoupursueyourcollegeeducation?Howdo youplanto overcometheidentifiedchallenges?

4. Imagine: Youarea ServiceLearning projectcoordinator.Pleasedescribeaservicelearning projectyou would coordinate?Whydidyouchoosethisproject?Howwouldyougetothersinvolved intheservice learning opportunity?

Note:Thinkaboutandwriteyouranswerscarefully.Yourresponsesareimportantintheselectionprocess.Pleasehave youressaysreviewedforgrammar,content,andspellingbyatleasttwoindividuals.

B.Recommendations

Pleaseasktwopeoplenotrelatedtoyou,butwhocanspeaktoyouracademicabilityandpotentialforsuccessin collegetowritealetterofrecommendationonyourbehalf.

Recommendationletters should come frompeoplewho are familiarwithyouracademicabilities,achievements, community involvement, and/orpotential for collegesuccess.Onerecommendation shouldbe froma teacher/professor, counselor/adviser, or principal. The other recommendation couldbe froman employer or communitymember.Recommendationsshouldnot come froman immediate familymember, classmate, peer, or friend.Pleasehavethewriterincludethefollowinginformation:academiccapabilities,motivation,personal characteristics,experiences,and achievements.Besurethattheyincludethefollowingonallletters:student’s name,ownnameandtitle,relationshiptostudent.

C.Indicateschool/communityactivitiesinwhichyouhavebeeninvolved(Attachaseparatesheetif necessary).

School(clubs,government,sports,etc.)Dates

Community Service/Community Involvement Dates

(familyobligations, tribal participation,religiousgroupparticipation,clubmembership,volunteeractivities,etc.)

D.Pleaseindicateallawards,honors,specialtalentsorinterests(Attachaseparatesheetifnecessary).

Awardsandhonors

Specialtalentsorinterests

E. FinancialInformation: ONLY COMPLETE THISFORM IF YOUHAVE NOT BEEN AWARDEDFINACIALAID

Areyou currently employed?Yes No| Ifyes,whoisyouremployer? What is the average number of hours your work per week?

Doesyouremployerprovidetuitionassistance?Yes No| Ifyes,whatistheamount$Pleaselistyourcurrentfinancialstatusandtheprojectedincome/expensesasspecifiedbelow.

Pleaselistyourtotalprojectedearningsfromworkingin2016.$Please project your earnings through the 2017-2018 academic year. $

Ifyou parent/spouse/otherhassupportedyouinthelastyear,whatistherelationshipandtheamount? Relationship $

Pleaselistcurrent“outsidesources”ofadditionalfundingforschoolandprojected“outsidesources”ofadditional fundingforschoolforthe2017-2018academicyear.

AcademicYear2017-2018

PersonalLoans$ Scholarships$Scholarships$

Otherfunds$Otherfunds$

Asoftoday,whatisyour(andspouse’s)totalcurrentbalanceof

Cash Savings Checking

DebtsOwingto:Amountowed

Pleaselistallpresenteducationaldebtsandamountowed:

$

$

$

$

$

Please Estimate total educational cost to attend PSU for the 2017-2018 academic year:$

Pleaseusethespacebeloworattachaseparatesheettodescribeand/orclarifyanyfinancialissues,expenses,or constraintsthat

arenotaddressedinthesectionaboveandtoexplainanysignificant($1,000)changestoyour financialneedfortheupcoming

2017-2018academicyear.

Checklistforthe2017–2018DiversityScholarshipApplication

AppliedforadmissiontoPortlandStateorcurrentlyaregularlyadmittedstudent

Completedandsignedthisscholarshipapplicationform

Answeredallfourrequiredessayquestions

Transcript(s)areincludedwiththisapplication:

•Iamahigh-schoolseniorandIhaveattachedacopyofmyhigh-schooltranscript

(Copiesofunofficialtranscriptsareacceptable)

•IamacollegestudentandIhaveattachedacopyofallmycollege-leveltranscripts

(Copiesofunofficialtranscriptsareacceptable)

Twolettersofrecommendation

Copyofcurrentfinancialaidawardorcompletedfinancialinformationsheet(includedinpacket)

IherebyauthorizePortlandStateUniversitytofurnishcopiesofmyacademicrecord,thisapplication,and

lettersof recommendationtothePSUDiversityScholarshipCommitteetoreviewinconsideringmy application.

Ifurtherauthorizereleaseofinformationforpublicitypurposes(ifselectedforascholarship).

Applicant’sSignatureDate

PSUsupportsequalopportunityinadmissions,education,and useof facilitiesbyprohibitingdiscriminationinthoseareasbasedon race,color,creedorreligion,sex,sexualorientation,genderidentity,nationalorigin,age,physicalormentaldisability,orveteran status.

Returnto:DiversityandMulticulturalStudentServices

Multicultural Retention Services

SmithMemorialStudentUnion425

Mail code:DMSS PortlandStateUniversity POBox751

Portland,OR97207-0751

Fax: (503) 725-5462

PortlandStateoffersawidevarietyof scholarshipstomeettheneedsof ourdiversestudentbodywithscholarshipsbasedon:

• Academicachievement / • Specificmajorand careerchoices
• Financialneed / • Firstgenerationstatus
• Diverseand uniquebackgrounds / • Servicetoschooland community
• Leadershipskills / • Disabilities

For more information please visit the following website: